This GOP lawmaker wanted to secure funding for roads. Enraged conservatives sent him death threats

There was never a question that U.S. Fred Upton (R-St. Joseph) was going to vote for the bipartisan Infrastructure Investment and Jobs Act.

The $1.2 trillion legislation, which Democratic President Joe Biden signed into law last month, sends billions of dollars to Michigan to repair crumbling roads, expand internet access, invest in ports, clean up the Great Lakes, and replace the aging lead pipes that have tainted the water in communities like Benton Harbor and Hamtramck, among a slew of other initiatives, the congressman emphasized in a phone interview with the Advance on Monday.

Plus, in a country increasingly dominated by partisanship, funding infrastructure is something the majority of Americans can agree on — even when former President Donald Trump opposed the act because it was championed by Biden and followed Trump being unable to pass a similar, but more expensive, proposal, during his presidency.

So almost exactly one month ago, Upton, who represents the 6th District encompassing Kalamazoo and a large swath of Southwest Michigan, voted for it. Immediately after, a Republican colleague of his, far-right U.S. Rep. Marjorie Taylor Greene (R-Ga.), called Upton and the other 12 Republican House members who voted for the bill “traitors” in a tweet (none others were from Michigan). In another tweet, Greene posted the phone numbers of those 13 Republicans.

After that, a flood of phone calls rushed into Upton’s office — more than 1,000 in a matter of days, the Michigan congressman said in a weekly email he sends to constituents. There were death threats and threats to Upton’s family and staff — a whirlwind of profanity-laced tirades rooted in a political environment more toxic than anything Upton said he’s seen in his 35 years in Congress.

“You know, it’s really troubling,” Upton said during Monday’s interview. “I’ll say most of the calls were from out of state, but were pretty nasty.”

The Federal Bureau of Investigation (FBI) and other law enforcement agencies have been investigating the calls, which brings Upton some relief, but the threats “are pretty scary,” he said.

In one voicemail left for Upton, an individual said, “I hope you die. I hope everybody in your f–king family dies.”

The caller also called Upton a “f–king piece of sh-t traitor.”

“It’s scary,” Upton said. “You know, I’ve got young staff with families. [The messages] are very threatening and really troubling. I mean, it’s not what democracy should ever stand for. We’re a nation of ideas; we can disagree on ideas. But we don’t have to be so disagreeable in terms of real personal threats.”

That idea of respectful disagreement is one routinely cited by Upton, who was first elected in 1986 and is the current dean of the Michigan congressional delegation. He has served under Presidents Ronald Reagan, George H.W. Bush, Bill Clinton, Barack Obama, Donald Trump and Biden. During his decades in the House, it has been controlled by both parties and he frequently calls Democratic colleagues like U.S. Reps. Debbie Dingell (D-Dearborn) and Elissa Slotkin (D-Holly) “good friends.”

“I’m a member of the Problem Solvers Caucus, and we take a civility pledge,” Upton said of a group of House members who aim to foster bipartisan cooperation among lawmakers. “We pledge we’re not going to work against each other. We can disagree on the issues, but it doesn’t mean you have to be disagreeable.”

It’s not just Upton who has faced an increasingly hostile landscape, he noted. Violent threats against congressional members are expected to double this year, the New York Times reported in November. Upton’s Republican colleagues who voted for the infrastructure bill have faced the same menace he has, from a caller telling Rep. Adam Kinzinger (D-Ill.) to slit his wrists and “rot in hell” to another saying Rep. Don Bacon (R-Neb.) would fall down a staircase.

Closer to home, Dingell reported last week that her office was vandalized after receiving months of threats. Nothing was taken, but the door and windows were broken, as was memorabilia of her late husband, former U.S. Rep. John Dingell (D-Dearborn).

“They didn’t take TVs or computers or phones; they ransacked it to send their own message,” Upton said of Dingell’s office. “It’s very troubling as you look at public service.”

Across the state and country, public officials, from congressional members to school board representatives and public health leaders, are facing increasing public hostility that academics previously told the Advance is rooted in the often aggressive and violent rhetoric that emanated from Trump and his former administration and has now bled into Republican politics at the state and local levels.

The New York Times reported last month that “threats of violence are becoming commonplace among a significant segment of the Republican Party.” A February 2021 study from the American Enterprise Institute (AEI), a right-leaning Washington, D.C.-based think tank, found that a majority, 56%, of Republicans “support the use of force as a way to arrest the decline of the traditional American way of life.” Meanwhile, 35% of independents and 22% of Democrats said the use of force is necessary to “stop the disappearance of traditional American values and way of life,” AEI wrote.

The Republican lawmakers who face heightened hostility are those who cross party lines to vote for legislation backed by Democrats. Before the infrastructure bill passed, Trump lambasted conservatives who supported it as “RINOs,” or Republicans in name only, and said they should “be ashamed of themselves.” In turn, Upton said that led to the disturbing threats against him and his colleagues who voted for the infrastructure legislation.

“Some of the anger that was sent to those of us that voted for [the infrastructure bill] was the fact that Trump opposed it,” Upton said Monday.

Upton went on to note that Trump had tried in 2020 to pass a $2 trillion infrastructure bill but wasn’t able to.

“He had no pay for it; he was simply going to add it to the debt or raise gas taxes,” Upton said. “We rejected those ideas.”

When it became clear that Biden’s infrastructure proposal was gaining traction, some Republicans “said, ‘Just wait until we get a Republican president maybe in ‘24 or ‘28,’” Upton said. “Well, we can’t wait. I came to govern. We’ve got someone in Lansing now who ran on the theme, ‘Fix the damn roads.’ Well, you can’t fix them without money.”

Democratic Gov. Gretchen Whitmer’s gubernatorial campaign slogan was “fix the damn roads.”

Upton also noted that the United States lags behind other countries when it comes to infrastructure spending, another reason he voted for the bill.

“China spent more in three years on cement than we have spent in the last 100 years,” he said. “If we want to emerge at the end of the century as a global leader on trade and everything else, we better get with it on infrastructure. Whether it be broadband or roads and highways, this bill is a start but it’s not a finish.”

It’s not just his support for the infrastructure bill that has ended in Upton facing violent rhetoric from members of his own party. The Michigan lawmaker has faced intense backlash from Republican colleagues at both the federal and state level in recent years, particularly after he broke with his party and voted to impeach former President Donald Trump for inciting the Jan. 6 insurrection at the U.S. Capitol to try and overturn the 2020 election he lost.

Michigan Republican Party Chair Ron Weiser, for example, casually referenced assassinating Upton and U.S. Rep. Peter Meijer (R-Grand Rapids), who also voted to impeach Trump. During a North Oakland Republican Club meeting in March, an audience member asked Weiser what should be “done” about Upton and Meijer after the impeachment vote.

“Ma’am, other than assassination, I have no other way … other than voting [them] out,” Weiser said.

At the same meeting, Weiser called Whitmer, Attorney General Dana Nessel and Secretary of State Jocelyn Benson “witches” that Republicans need to defeat in 2022 by “burning at the stake.”

Later, Weiser apologized for his statements, saying, “in an increasingly vitriolic political environment, we should all do better to treat each other with respect, myself included.”

“I fell short of that the other night,” Weiser said in a statement to The Hill. “I apologize to those I offended for the flippant analogy about three women who are elected officials and for the off-hand comments about two other leaders. I have never advocated for violence and never will.”

After Upton voted to remove Greene from her spot on the House Education Committee following her statements supporting QAnon and calling school shooting false flag operations, he was censured by the Cass County GOP.

“Tonight, the Cass County GOP censured me for voting to remove Marjorie Taylor Greene from the education committee, and in their resolution they stated that ‘her comments have not been out of line with anyone else’s comment.’ Really?” Upton tweeted on Feb. 23.

“She taunted a Parkland school shooting survivor, argued that California wildfires were started by a Jewish space laser, accused Democratic politicians of running a pedophile ring out of a pizza parlor, and questioned whether 9/11 really happened,” Upton wrote on Twitter.

More recently, Upton did not back a November House resolution to censure U.S. Rep. censure Rep. Paul Gosar (R-Ariz.) and strip him of his committee assignment, following Gosar’s social media post that depicted him killing Rep. Alexandria Ocasio-Cortrez (D-New York). Upton’s office said they had no official statement on the vote. The Michigan congressman told a CNN reporter that the resolution goes “a stretch too far” by removing Gosar from his committees and that he would have been more comfortable backing solely a censure resolution.

Congress is a wildly different landscape than it was when he first took office in 1987, said Upton, who worked in the Reagan White House and for former Senate Majority Leader Bob Dole, who died Sunday, before making his own bid for office.

“I’ve never seen things as toxic as today,” Upton said. “We lost Bob Dole yesterday, and he was a wonderful, dear friend of mine. I actually worked in his office for a number of years. Things were a heck of a lot different then.”

“It’s pretty nasty out there,” Upton said.

It’s so acrimonious that officials are leaving their public jobs, including health officials in Berrien County, though Upton did not say whether or not the threats will stop him from running for reelection. State Rep. Steve Carra (R-Three Rivers) announced in March that he plans to primary Upton, after which he landed an endorsement from Trump.

“In Michigan, we lose a [congressional] seat [with the 2022 redistricting process],” Upton said. “We don’t know what the districts are going to look like yet. Some of my colleagues are talking about moving, but I’m not moving. I was born in St. Joe. That’s where my family is, and that’s where I”m staying. We’ve never made a decision to run in the year ahead [of an election]. We’ll make a decision probably not this year. We’ll figure it out.”

Michigan Advance is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Michigan Advance maintains editorial independence. Contact Editor Susan Demas for questions: Follow Michigan Advance on Facebook and Twitter.

Michigan secretary of state candidate Kristina Karamo to speak at QAnon conference

Kristina Karamo, a 2022 Republican Michigan secretary of state candidate endorsed by former President Donald Trump, is set to speak at an upcoming QAnon conference billed as the “Great Awakening Weekend" in Las Vegas.

Scheduled from Friday until Monday, the “For God & Country: Patriot Double Down" event is being organized by John Sabal, known as “QAnon John" who recently called for a “military mutiny" against President Joe Biden.

Its roster of speakers features a whirlwind of QAnon devotees who have dedicated good chunks of their recent lives to promoting the right-wing conspiracy theory that's rooted in anti-Semitic tropes and revolves around Trump hunting down and eventually killing Democratic politicians and wealthy liberals who lead double lives as Satan-worshipping cannibals running a child sex-trafficking ring.

Karamo, of Oak Park, confirmed on her campaign Facebook page that she will speak at the event, and she's also listed as a speaker on the event's official website that displays a promotional video filled with such QAnon phrases as “the truth will set you free" and “where we go one we go all." The video ends with the image of a playing card emblazoned with the words, “God wins."

“Come To The Patriot Double Down Where I will be speaking!!!" Karamo wrote earlier this month.

Karamo did not immediately return a request for comment for this story.

The Republican secretary of state candidate has not explicitly endorsed QAnon but she has consistently promoted the false and repeatedly debunked notion that the 2020 election was stolen and Trump is the true victor, an idea that's central to QAnon conspiracy theorists. Karamo gained national attention as a poll watcher in 2020, pushed unproven claims about Wayne County election practices before a state Senate panel, and traveled to Arizona for a so-called election “audit" that found no evidence the 2020 election was stolen.

Just last week, Karamo was on One America News Network, a far-right, pro-Trump cable channel, where she again repeated the false idea that “there was massive cheating and fraud in the election."

Karamo could potentially face state Rep. Beau LaFave (R-Iron Mountain) and Plainfield Township Clerk Cathleen Postmus for the GOP nomination. Voters will not pick the nominee; delegates at the Michigan Republican Party convention will in April. The nominee will likely face Democratic Secretary of State Jocelyn Benson.

One of the speakers at the “Great Awakening Weekend" is Jim Watkins, the owner of the 8kun website that is home to messages from “Q," the anonymous internet poster who launched the QAnon phenomenon by claiming to be a high-ranking U.S. government official with access to classified information. Jim Watkins' son, Ron Watkins, will also speak at the event. Ron Watkins has been accused of being “Q" himself and is now running for Congress in Arizona.

QAnon has found a prominent home among Michigan GOP activists in recent years. At a pro-Trump rally last week calling for a so-called “audit," state Rep. Daire Rendon (R-Lake City) wore a QAnon pin, which she has also donned in the Legislature.

The conspiracy theory was born in 2017 when an anonymous account posted on 4chan, one of the internet's oldest and most infamous message boards, and began writing about Trump's so-called secret war against a deep state cabal of pedophiles and sex traffickers.

The anonymous account, named “Q Clearance Patriot," went on to become known simply as “Q." The account has since made thousands of posts, known as “drops" in the QAnon world, first on 4chan, then on 8chan, another message board, and now at 8kun.

Each “drop" is cryptic, leading to followers attempting to decode the dizzying array of false information, from top-level Democrats being involved in child trafficking to the coming “great awakening," which Q followers have said essentially amounts to Trump leading the United States to greatness by unveiling the members and actions of the “deep state," or the group of dangerous top-tier government officials and other elite figures who are secretly running the world.

Michigan Advance is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Michigan Advance maintains editorial independence. Contact Editor Susan Demas for questions: Follow Michigan Advance on Facebook and Twitter.

Once lauded as heroes, health care workers are now spit on and 'threatened every day at work'

When Tom Kelsch heads to his job as a registered nurse in Mercy Health Muskegon's emergency department, he knows, almost without a doubt, that he'll be threatened by a patient or their family that day.

He knows he may see someone's fist in his face, as has happened in the past, or have to endure a barrage of angry words screamed at him.

“I get threatened every day at work," said Kelsch. “They say, 'I know where you live; I'll be visiting you.' They say they're going to come and kill me; they say, 'I know where you park and what you drive.' It's pretty awful what we deal with. I've been spit on."

These incidents are not new to Kelsch, or likely anyone who works in emergency medicine. Patients, facing extreme and life-threatening pain, can lash out, as can stressed and grieving families. Violence against health care workers has been on the rise nationally for years.

But during the COVID-19 pandemic, the frequency of these attacks have soared, Kelsch said.

“I started working in the [emergency room] 11 years ago, and every year it was slightly getting worse with patients verbally assaulting us, physically assaulting us — but since the pandemic started, it has gone up tenfold," he said.

Across Michigan, doctors, nurses and other medical professionals spoke to the Advance about workplaces increasingly filled with aggressive and violent patients and their family members: people who are angry over pandemic policies, such as mask requirements and visitor restrictions, and take it out on those trying to save their lives.

Workers described people throwing punches and hurling cascades of threats at them after long waits in understaffed emergency rooms. Others will yell at doctors because they don't believe their COVID diagnoses, and patients have threatened legal action if they don't receive ivermectin — a drug used to deworm horses that some prominent conservatives are pushing as a COVID-19 treatment despite a specific warning from the Federal Drug Administration not to do so.

It's a landscape filled with doctors and nurses exhausted by a pandemic that has now dragged on for more than a year and a half, staff who are leaving the field because they're burned out, and workers having to wear what essentially amounts to panic buttons so security can come running if they are attacked.

“There's a lot of anger towards health care workers in general," said Dr. Matthew Trunsky, a pulmonologist and the director of palliative care at Beaumont Hospital in Troy. “A year and a half ago, people were sending us party trays and food. All of a sudden, we're kind of the enemies. We're taking the brunt of families' anger."

“People are angry, and I think the anger is based on public misinformation on what works and what doesn't work to treat the disease," Trunsky added.

'When we are surging with COVID patients, we are experiencing a surge in aggression'

In the years leading up to the pandemic, health care workers across the country were increasingly reporting an uptick in physical and verbal attacks against them.

The U.S. Bureau of Labor Statistics reported in 2018 that medical workers accounted for 73% of all nonfatal workplace injuries from violence. Data from the U.S. Occupational Safety and Health Administration (OSHA) shows health care employees were, on average, nearly four times more likely to experience violence at work than individuals in private industry overall between 2002 and 2013.

A 2018 survey of about 3,500 emergency physicians in the United States reported 71% of the doctors had witnessed an assault, and 47% of the physicians were physically attacked themselves. Meanwhile, 97% of those surveyed stated the main source of the assaults was patients, and 83% said a patient had threatened to return to the health care facility to harm them. Nurses take on even more of the brunt of this violence, according to the Emergency Nurses Association, with 70% of emergency nurses reporting being the victim of physical assaults while on the job.

In Michigan, attacks against health care workers were becoming so pronounced in the year before the pandemic that the Michigan Health and Hospital Association (MHA) formed a “workplace safety collaborative" in March 2019 that aimed to address this surge in violence through de-escalation training and other efforts.

“We launched it after hearing for many months that frontline caregivers were suffering from abuse from patients, from family members of patients," said Brian Peters, the CEO at the MHA.

“The reality was if we didn't get our arms around this issue, you'd see a rise in burnout and folks who would leave the field, and it would get in the way of frontline caregivers' ability to provide quality care," Peters said.

The mounting violence in health care settings, particularly hospitals, has been significantly intensified by the pandemic, according to medical personnel. There's been a confluence of misinformation about the pandemic, such as the false idea that masks don't work to prevent COVID's spread — something a trove of major medical studies have repeatedly proved otherwise; an increase in mental health issues, including substance abuse; and longer wait times in emergency rooms due to staffing shortages.

All that has led to an explosive environment in which health care workers are routinely dealing with abusive patients, according to health care professionals interviewed by the Advance.

Like hospitals across the state and country, Spectrum Health in West Michigan has seen a spike in both verbal and physical assaults. Before the pandemic, there were about 100 verbal or physical acts of aggression reported monthly at Spectrum; now, that number is close to 350 incidents each month, according to Dr. Joshua Kooistra, the senior vice president and chief medical officer at Spectrum Health.

To deal with this surge, Kooistra said they've implemented a “staff duress system" in which employees wear a button they can push that sends their location to security. Spectrum, which operates hospitals and other health care facilities throughout West Michigan, is also “training staff and security in de-escalation techniques" to calm irate patients or family members, Kooistra said.

At Sparrow Hospital in Lansing, staff would have to deal with about one or two aggressive patients daily prior to COVID. That has grown to six or seven patients being physically or verbally abusive every day during the pandemic, Sparrow Hospital Chief Nursing Officer Amy Brown said. Like Spectrum, Sparrow has worked to increase both staff and patient safety through de-escalation training, and Brown said the hospital brought on a “trained dog" to accompany security officers attempting to quell patient aggression beginning in June 2020.

“We haven't had to use the dog in an aggressive manner, but we've used the dog to de-escalate situations," Brown said. “If there's a dog with a security officer and a person is acting out, the presence of the dog calms the situation down."

Kooistra said the abuse that happens against health care workers at his workplace now rises with the number of COVID patients.

“When we are surging with COVID patients, we are experiencing a surge in aggression," Kooistra said.

He added that there has been a “definite increase in aggression around masking."

“I think people have firmly held beliefs about the utility of masks," he said. “In health care, we require them. That can lead to aggression towards health care workers as the messenger [that patients must wear masks]."

It's not just that people are battling illnesses, tired of the pandemic and becoming more violent in hospitals, some of those interviewed said. It's that hospital staff are increasingly having to work with unvaccinated patients because they are now overwhelmingly the ones who are coming down with serious COVID cases and dying.

At this point in the pandemic, attitudes towards vaccination are heavily rooted in partisanship — your party affiliation is far more likely than any other factor, including age, race or ethnicity, to determine whether you get the COVID vaccine, according to a Sept. 28 report from the Kaiser Family Foundation.

“The largest remaining gap in vaccination rates is by partisanship, with 90% of Democrats saying they have gotten at least one dose compared to 68% of independents and 58% of Republicans," wrote the San Francisco-based Kaiser Family Foundation, a nonprofit focused on national health issues.

Those in conservative areas are also far more likely to die from COVID. Charles Gaba, a health care analyst based in Bloomfield Township, reported in September that, since June, the virus has killed about 47 out of every 100,000 people in counties where former President Donald Trump received at least 70% of the vote in 2020 against now-President Joe Biden. Meanwhile, COVID has killed about 10 out of every 100,000 people in counties where Trump garnered less than 32% of the vote.

With partisanship dominating views towards vaccination, that in turn lends itself to an unvaccinated population often aligned with a variety of attitudes around health care and the pandemic in general that are rooted in what the Washington D.C.-based think tank the Brookings Institute calls a “seemingly intractable cultural divide in American society between the parties." If you're an unvaccinated patient battling COVID-19 in the hospital right now, you're more likely than those who are vaccinated to be Republican and opposed to a variety of COVID-19 health measures, such as masking and vaccine mandates for workplaces.

“There's this divisiveness that's occurred in society," Kooistra said. “People have firmly held beliefs that they're unwavering on, and they're not having grace with one another. …The safety measures, such as masking, social distancing and some visitor restrictions — I'd ask the general public to be a little more understanding of why those are in place. Have grace with us. It's not the health care worker who's trying to take care of you who's responsible for those requirements."

But right now, some patients are not heeding calls for patience. At Beaumont, for example, patients have become angered over COVID diagnoses and refuse to believe they have the disease, Trunsky said. Some will say “you'll hear from my lawyer" if the hospital doesn't give them ivermectin — the horse dewormer that is now being pushed by some high profile Republicans as a treatment for COVID — while others will tell their caregivers that they would rather die than get the vaccine, Trunsky said.

“There was a woman whose husband died of COVID who said she would never feel comfortable recommending the vaccine for family and friends," said Trunsky, who has lost about 100 patients to COVID.

“Ninety percent of our [COVID] patients are unvaccinated; 90% of deaths are unvaccinated," he continued, referring to national statistics. “The vast majority of them are unnecessary. To argue in any way that the vaccine doesn't work is dishonest, and it's resulting in the deaths of fellow Americans."

'They are completely out-of-their-minds mad at the whole situation'

In addition to misinformation about the pandemic, health care workers cited an increase in mental health challenges during the pandemic and growing wait times in emergency rooms due to staff shortages playing roles in the surge of aggression from patients.

Sparrow Hospital in Lansing, for example, has seen an increase in patients with “mental health needs that are going untreated and increased abuse of alcohol and drugs; more people are coming in under the influence," said Brown, the hospital's chief nursing officer.

In Michigan, about two-thirds of adults reported feeling depressed, down or hopeless to varying degrees in September, according to the U.S. Census Bureau's “Household Pulse" survey. The bureau's ongoing survey aims to collect data on a wide variety of issues, from mental health to housing insecurity, during the COVID-19 pandemic.

About 20.8% of Michigan adults reported feeling that way every day over the course of two weeks in September, the survey said. Approximately 17.8% of Michigan adults reported feeling depressed, down or hopeless more than half the time in the past two weeks, while 29% said they felt that way several days a week over the same time period, according to the survey. About 32% of Michigan adults said they experienced no depression.

These numbers are far greater than pre-COVID statistics. According to the Kaiser Family Foundation, one in 10 adults reported symptoms of anxiety or depressive disorder in 2019. About 12% of adults nationwide reported drinking more during the pandemic, the Kaiser Family Foundation reported.

Kooistra said that Spectrum Health too can attribute some of the patient aggression to “an increase in mental illness" and a rise in substance use. Kelsch, the nurse at Mercy Health in Muskegon, attributes much of the rise in patient violence to individuals having difficulties accessing care from primary physicians during the pandemic and ending up seeking care in an understaffed emergency room.

Health care facilities state- and nationwide have struggled for years to find nurses; now, that shortage is even greater because pandemic burnout is pushing workers from the field, according to those interviewed by the Advance. Currently, there are some 12,000 listings on the job site for registered nurse positions in a variety of health care settings in Michigan, including hospitals.

“It's very difficult for patients to get in and see their primary care doctors," Kelsch said. “By the time they get to the ER, they're frustrated. The family is even more frustrated. They come to the ER, and they are completely out-of-their-minds mad at the whole situation."

“There have been multiple times when the patient is waiting four, five hours in the [emergency department] to be seen," he continued. “I have patients physically bring their fist up to me and punch me because they're mad that someone got [to be seen by a doctor] before them."

If Trinity Health, the parent company for Mercy Health in Muskegon, negotiated the nurses' contract that has been expired for more than two years, Kelsch said he believes the facility would be able to fill open positions with “competitive wages."

“We've been trying to sit down at the table with Trinity, but they won't," he said. “They refuse to give us a competitive wage. We stay because this is our community, and we want to be able to take care of the community we love. But pay us what we're worth, and you won't have a nursing shortage. The staff shortage is staff burnout."

In a statement provided to the Advance, Mercy Health said its “leadership has not declined to meet for contract negotiations."

“In fact, we initially commenced negotiations with SEIU in September 2019," the statement said. “Due to a representation election between our two nursing units, these negotiations were paused until after the election. Mercy Health has since been meeting with SEIU regularly since February 2021 to negotiate a contract for our registered nurses and are looking forward to signing an agreement with SEIU that is fair and sustainable for both parties."

A representative for SEIU, Kevin Lignell, backed Kelsch's statement and said Mercy Health is “stalling" on negotiations.

With regards to increasing nurses' pay, Mercy Health said, “unfortunately, until we reach an agreement, we are unable to make adjustments to wages." The hospital said it has “offered several bonus pay plans such as retention, critical staffing and COVID incentives for our nurses and other staff members, which the union has opposed."

Legislation aims to protect health care workers

Federal and state lawmakers have also begun taking aim at the increase in violence against health care workers.

In April, the U.S. House passed the Workplace Violence Prevention for Health Care and Social Services Workers Act — a bill introduced by Rep. Joe Courtney (D-Conn.) and co-sponsored by 145 other members, including five Michigan Democrats: U.S. Reps. Andy Levin (D-Bloomfield Twp.), Debbie Dingell (D-Dearborn), Dan Kildee (D-Flint), Haley Stevens (D-Rochester), and Rashida Tlaib (D-Detroit).

The legislation, which garnered bipartisan support in the House and which the Senate has not voted on, would require OSHA to mandate that health care and social service employers develop and implement workplace violence prevention plans. It would also require that employers provide further training and education on workplace violence and adopt policies that protect employees from retaliation for reporting violent incidents.

“Front line workers should be able to trust that they will be protected in the workplace and get home safely at the end of the workday," Kildee said in a statement to the Advance.

“This legislation will protect the brave health care and social services workers who are working tirelessly during this pandemic to keep Michigan families and communities healthy," he continued.

Also in April, state Sen. Jeff Irwin (D-Ann Arbor) introduced a bill that would require hospitals and public health departments to track and disclose incidents of violence, develop plans to prevent workplace violence with input from nurses and other frontline health care workers, and provide training and reporting procedures for employees. The bill stipulates that health care institutions must publish information about incidents of violence on their respective websites.

Should the legislation pass, it would require that hospitals report incidents of violence to a county prosecutor — something the lawmaker said they are currently reluctant to do because, often, those perpetrating the crimes “are their customers," Irwin said, referring to patients.

“There's a built-in incentive not to report these incidents or sweep them under the rug," Irwin said. “My bill focuses on preventing these instances. … If a prosecutor wants to look at a case and decide not to prosecute, that's one thing, but if a hospital is making that determination, that seems like a problem. The legislature needs to step in."

So far, no committee hearing has been scheduled for Irwin's legislation.

“I think the reason this legislation hasn't seen any action is because hospitals don't want this," Irwin said. “It requires them to post information they don't want to post."

But, ultimately, Irwin said, it only helps the public and hospitals to fully acknowledge and address violence against workers.

“Working in health care is always challenging, and has been especially challenging over the last couple of years," Irwin said. “There are a whole lot of leaders who say we need to respect these health care workers. One way the legislature can show a sign of appreciation is to pass legislation that protects them from violence."

“It's going to be hard to recruit people into these jobs if they're dangerous and the community doesn't have their back," Irwin added.

'Geez, I'm just going to throw in the towel': The toll of aggression

As the pandemic stretches on, unvaccinated individuals crowd hospitals and patients become increasingly violent. Health care workers are facing significant burnout that's pushing them from the field in Michigan and nationwide, those the Advance interviewed said.

“It's definitely exacerbating burnout," Kooistra said of the increased violence against hospital employees. “Our staff are taxed with increased patient care volumes and more limited resources. You put on top of that patients or families who are aggressive against team members, and you start to say to yourself, 'Geez, I'm just going to throw in the towel.'"

According to a study conducted by the American Medical Association, 49% of 21,000 frontline health care workers surveyed from May to October of 2020 reported experiencing burnout.

“That's a rate that's higher than any other sector I can think of," said Peters, the CEO of the Michigan Health and Hospital Association.

“Burnout is on the rise," Peters continued and said that can, in part, be attributed to patients and their family members “getting very frustrated and upset" over elective procedures being shut down at the beginning of the pandemic and restrictive visitor policies, which were put in place in order to mitigate the transmission of COVID-19.

“In too many instances, they took that out on hospital employees and, in some cases, got incredibly threatening and physically violent to the point where security had to intervene," Peters said. “That contributes to burnout."

On top of the violence is the fact that doctors and nurses have had to watch as their patients die from COVID-19, Peters said.

“We walk with nurses all the time who tell us they've held an iPad by the bedside so the family of a patient can watch their loved one die," Peters said. “You do that a dozen or more times, as many of our nurses and doctors have done, and now you're talking about a real potential for burnout. We have had over 20,000 Michiganders who have died from COVID — the story I just said is not just a dozen here, a dozen there. It's 20,000 of those."

Addressing this burnout is complicated. Hospitals are providing mental health support to their staff, Peters said, but he and others emphasized the public has to change for health care workers to begin healing from the trauma that has taken root during this pandemic.

“At the beginning [of COVID-19], our frontline caregivers would see the hero signs, banners and ads on TV and radio; that was uplifting," Peters said. “Some of that has faded, and unfortunately we see these instances of violence and distrust. We would harken back to the earlier days of the pandemic, when they were rightly hailed as heroes. They still are."

But it's more than just public recognition that's needed, Trunsky said. It's a public that is willing to recognize what it will take to ultimately end the pandemic: Getting the vaccine.

“The frustration is the vast majority of these illnesses are preventable," he said, referring to COVID-19. “… There's a social responsibility that I think is being overlooked in favor of individuals' civil rights, and as a country we're paying the price with hundreds of thousands of deaths."

Michigan Advance is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Michigan Advance maintains editorial independence. Contact Editor Susan Demas for questions: Follow Michigan Advance on Facebook and Twitter.

'I need help': Michigan health official troubled after almost being run off the road by anti-maskers

After a woman attempted to run Kent County Health Department director Adam London off the road just hours after he issued a mask mandate for some schools last month, the health officer issued a plea to the Kent County Board of Commissioners.

“I need help," London wrote in an Aug. 22 email to the county commissioners, which Michigan Advance received today after filing a Freedom of Information Act (FOIA) request with the Kent County Board of Commissioners last week. “My team and I are broken. I'm about done. I've done my job to the best of my ability. I've given just about everything to Kent County, and now I've given some more of my safety."

London's email followed his announcement on Aug. 20 that masks would be required for anyone in preschool through sixth grade school buildings in Kent County in order to prevent the spread of COVID-19. Kids under 12 are not eligible for the COVID-19 vaccine.

The decision to mandate masks in schools is supported by the U.S. Centers for Disease Control and Prevention, the American Academy of Pediatrics, the Michigan Department of Health and Human Services, and a long list of groups local to Kent County, including Helen DeVos Children's Hospital, Mercy Health Saint Mary's, and Metro Health — University of Michigan Health, among others.

Despite this support, London and other members of the Kent County Health Department have received vitriolic criticism, as well as threats of violence, over the mandate. At an Aug. 26 Kent County Board of Commissioners meeting, a large and often raucous crowd spewed harsh and aggressive words for London, who had to attend the meeting virtually due to concerns for his physical safety.

“I had a woman try to run me off the road at 70+ miles per hour…twice, on Friday night," London wrote in his Aug. 22 email to commissioners. “I think we have all seen the aggression and violence displayed at meetings across the nation during the past week."

“There is nothing to be gained by entertaining such people with dialog," London continued. “In many cases, these are the same people who dismiss the plot against the governor [Gretchen Whitmer] as “just guys joking around" and the January 6th insurrection [at the U.S. Capitol] as a peaceful patriotic protest. I think it is a grave mistake to unnecessarily give them targets and platforms. There is a sickness in America far more insidious than COVID. You are more empowered to fight this disease than I am."

London declined to comment for this story. The Kent County Sheriff's Office said in a Sept. 21 statement that Kent County Undersheriff Charles DeWitt was contacted directly by London on the evening of Aug. 20 “about a traffic incident that had occurred on U.S. 131."

“Dr. London informed Undersheriff DeWitt that an individual had attempted to run him off the expressway two times while he was traveling," the sheriff's office wrote.

“While Dr. London was able to provide the make of the vehicle involved, he was unable to get a license plate number or provide a detailed description of the vehicle," the sheriff's office continued in it statement. “Dr. London was given options as to when he could file a report; however, no report was filed with the Kent County Sheriff's Office."

Across Michigan, local health and education officials have increasingly faced aggression and threats of violence, including death threats, after issuing school mask mandates. Last school year, the state Department of Health and Human Services (DHHS) required masks, but has left it up to local officials this school year. The DHHS has said it is advocating, but not requiring, that schools implement indoor masking policies to prevent the spread of COVID-19. Whitmer has said state officials are focusing on local districts implementing school mask policies because they believe residents will be more likely to follow those requirements than if they came from the state.

“We are relying on school districts to work with our local public health experts to develop policies and enlist the support of the community. We know that broad mandates are only so effective, and when they happen at the local level it increases compliance," Whitmer told reporters earlier this month at an event in Kent County.

However, that decision has left local health and school officials to become the targets of public ire — and that, London said, is taking a deep toll on health department employees, himself and his family.

Last week, I had a person yell out to me, “Hey mother******, I hope someone abuses your kids and forces you to watch.

– Email from Kent County Health Department director Adam London

In his Aug. 22 email to commissioners, in which the health officer provides extensive data supporting the county's school mask requirement, London paints a dark picture of the abuse he has faced, from people “accusing me of being a deep state agent of liberal-progressive socialist powers that are working to undo the America they love (paraphrased minus expletives)" to others calling him a “child-abusing monster."

“Last week, I had a person yell out to me, “Hey mother******, I hope someone abuses your kids and forces you to watch," London wrote.

London's “health, my family and now our safety have paid a price for my work over the past year and a half," the health officer told county commissioners in his email.

“I want you to know that I will not needlessly expose myself (or my family for that matter) to the brute mob hatred that is crudely evident in a vocal and energized minority," London wrote. “These are people who hope to force their views on others through intimidation, aggression, and their rhetoric suggests violence as well. I will not participate in witch trials in which the science I've presented, and the opinions of legitimate experts, is reduced to the same stage as people living in echo-chambers of junk science, salespeople, and Youtube videos. For the leaders of these misinformation campaigns, it's never really been about our data; it's been about their dogma."

Melissa Ryan, the editor of the Ctrl Alt-Right Delete newsletter and an expert on extremism, emphasized this idea in a recent interview with Michigan Advance. The vitriol lobbed at local health and education officials is often perpetuated and exacerbated not by local residents but through right-wing talking points and national funding campaigns, Ryan said.

Personally, I don't believe they have the authority to implement a mask mandate and should they try, I will refuse to follow their mandate and encourage others to disobey this overreach into people's lives.

– Rep. Stephen Johnson (R-Wayland)

“You can't really talk about what's happening in Michigan without talking about other states," Ryan told the Advance. “It's national politics and national money and strategy being spent to pit neighbor against neighbor in school districts."

It's not just attending large commission meetings who have hurled intense criticism for London and health department employees. Four West Michigan Republican state legislators — state reps. Thomas Albert (R-Lowell), Mark Huizenga (R-Walker), Steven Johnson (R-Wayland), and Bryan Posthumus (R-Cannon Twp.) — recently threatened to pull funding from the Kent County Health Department if masks are mandated in schools.

“Along with several of my colleagues, I've sent a letter to the Kent County Health Department calling on them to avoid implementing any mask mandates," Johnson wrote on his official government Facebook page on Aug. 16. “Personally, I don't believe they have the authority to implement a mask mandate and should they try, I will refuse to follow their mandate and encourage others to disobey this overreach into people's lives."

And after members of the public called on Kent County commissioners to rescind the Health Department's mask mandate, both the county's in-house legal team and an outside counsel group, Warner Norcross & Judd, concluded that is not legal.

“Both opinions concluded that neither the Kent County Board of Commissioners nor the County Administrator/Controller have the authority to intervene in the health officer's performance of his statutory duties under Michigan's Public Health Code," the county wrote in Sept. 8 statement.

Members of the public also have called on London to resign, or for the county to fire the health officer.

These are people who hope to force their views on others through intimidation, aggression, and their rhetoric suggests violence as well. I will not participate in witch trials in which the science I've presented, and the opinions of legitimate experts, is reduced to the same stage as people living in echo-chambers of junk science, salespeople, and Youtube videos.

– Email from Kent County Health Department director Adam London

“If you want to fire me, or censure me, or pass a resolution condemning me, by all means please proceed," London wrote in his Aug. 22 email. “Do what you need to do your job. But first, let me share my prayer with you: I pray that people more powerful than me, Democrats and Republicans, rise up with one voice and say, 'we will not tolerate or provide quarter for this nonsense in our part of America.' Public service is honorable and noble. Change the laws if they're not good; don't destroy the people who are carrying out laws you don't like. If people like Adam London aren't going to keep doing this work, who will?"

In response to the threats of violence London has received, Democratic Kent County commissioners issued a statement of support for the health officer and the county health department. Republican commissioners were asked to sign their names to the statement from Democrats; none did so.

“Many Kent County employees have been stretched to the breaking point during the pandemic, but none more so than those in the Health Department," reads the statement from Democratic County Commissioners Phil Skaggs, Michelle McCloud, Carol Hennessy, Melissa LaGrand, Dave Bulkowski, Robert Womack, and Stephen Wooden.

Kent County Board of Commissioners Chair Mandy Bolter and Vice Chair Stan Stek, both Republicans, did not respond to repeated requests for comment for this story. Following the story's publication, Bolter issued a statement on Sept. 21.

“As a large and diverse county, we will not agree on every issue," Bolter said. “However, we are one community and we should hold ourselves to the highest standard of public discourse. Threats of violence against any resident or county employee is, without question, unacceptable and should be immediately reported to the proper authorities."

The Democratic commissioners said their Sept. 15 statement was issued “in absence of official public support from the Board of Commissioners."

“We have been shocked to learn that [London] and his family have received threats to their physical safety and disheartened to see his reputation abused in public forums," the Democratic commissioners wrote. “While it is our wish that all Kent County Commissioners would unite in publicly supporting [London] and his team, we will not wait to express our gratitude for the Health Department and [London]. We support the August 20th health order requiring mask use in PK-6 educational settings and appreciate their work to keep the people of Kent County healthy and safe in the face of a serious threat."

Skaggs, a Democratic commissioner who represents portions of southeastern Grand Rapids and East Grand Rapids, said in an interview with Michigan Advance that “every member of the county commission is aware of the threats to Adam London and the Health Department and the attempted vehicular assault against Adam London."

We were hoping that the Republican leadership would take action, and they did nothing.

– Democratic County Commissioner Phil Skaggs

“We were hoping that the Republican leadership would take action, and they did nothing," Skaggs continued. “We felt it was necessary for us to [issue the statement], even if we had to act alone. I encouraged them to sign onto the statement. I think unfortunately some of them agree with the message that masks are ineffective, that the pandemic is a hoax, and that the vaccine is unproven and dangerous, but I think the majority of them are simply unwilling to take a courageous stand on behalf of public health."

In his email to commissioners, London wrote that “because my character is under attack," he wanted the elected officials to know more about him.

“I am a Christian, and I embrace my job because it is an expression of that working faith," he wrote. “ … I attend church on Sundays and holy days, pray and study every day, and you can often find me spending my lunch hour at St. Andrew's Cathedral attending noon mass and praying for you, my co-workers, the people of Kent County, and the wisdom to do my job well.

“Others are calling me a traitor to our nation and liberty who must be stopped at all costs," London wrote. “Really? I'm the grandson of two WWII heroes, the son and step-son of men who served during Vietnam, and the brother of a soldier who served in Afghanistan. We proudly wave the flag at my house and in my office. Faith, Family and Country."

Ultimately, London told commissioners, he hopes elected officials will take a hard look at themselves and how they are doing their own jobs.

“I also believe it would be more helpful for the legislature to work on new laws which better protect rights and public health instead of attacking public servants," London wrote.

Michigan Advance is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. Michigan Advance maintains editorial independence. Contact Editor Susan Demas for questions: Follow Michigan Advance on Facebook and Twitter.